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Have you found Apple’s hidden health tool?

This post is by Amanda Anderson. Amanda is a 2013 Graduate Fellow who is now transitioning into the HealthCetera editorial team. She writes for a number of health care blogs and for herself, works in hospital nursing administration in NYC, and studies at Hunter-Bellevue School of Nursing where she runs the HBSON E-Writing Center. Amanda bikes, and occasionally tweets @12hourRN

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Not many twenty-somethings wear medical alert bracelets, or think much about about things like medication lists or emergency contacts. Birth control and daily vitamins don’t really call for inscribed pewter accessories, and many of my friends have even less than that to keep track of. But as a nurse, I’ve seen the complications that lack of accessible medical information can cause, and creating a way of letting providers know my info in the event that I can’t tell them myself is important to me.

For years, I slipped a business card inside my cellphone case with a few important names scribbled on it. Later, I found out that Siri could be accessed through a locked phone, so I set my iPhone to allow this, hoping whoever found me, in whatever emergency might befall me, would know enough to tell her to dial my “Moom.”

But recently, after I [belatedly] upgraded to iOS8, I realized that Apple has taken a giant step in helping me make my med info accessible: Medical ID. This function, which can be accessed while a phone is locked and an emergency call is attempted, can house everything from the name of your health care proxy to your list of meds, diagnoses, doctors’ contact info, and anything else you’d like to tell those attempting to save your life. To update this information and create your personal “emergency card,” you simply add what you want to be seen via Apple’s new Health app.

Lest you be swayed by laziness or confidentiality concerns, let me tell you why I didn’t hesitate to update my phone with my emergency contact (who knows all of my medical info), doctor’s name and blood type, as soon as I noticed the red Medical ID icon lurking in the corner of my emergency call screen:

I’ll never forget the young man that was beaten until brain dead on a street in the city I first became a nurse. His body remained in our ICU for weeks before a family member came forward to identify it. Another time, a young girl took a bad mixture of drugs at a nearby party – she arrived to my unit in the middle of the night, cell phone locked and contacts days away from finding her whereabouts. These, and my daily bike route around New York City, serve as pretty convincing personal motivators.

With that being said, I find it odd how little attention this pretty rad feature is getting in health policy news. Not only does the Medical ID allow users to store and safely share vital information about their medical care, it recognizes the life-tie we have to our phones, and the important part that they play in our daily health. If phones move past exercise and calorie trackers into the realm of care coordination, as they likely should, health care culture must shifts towards them. Coordinating your own medical records via your most-used device seems like the natural first step toward personal health promotion.

While I found a few comparable Android apps (Medical ID, ICE, to name a few), it seems that they all have to be downloaded, and some paid for, where Apple’s is part of its most recent software upgrade. The company’s commitment to health is pretty incredible, actually; you can set a Medical ID, coordinate your providers, and even participate in clinical trials via your iPhone.

To be fair, this post isn’t an Apple-sponsored advertisement. Their new health app has been criticized for many things; leaving out a period tracker for women is one that’s high on the boo-list. Further more, relying on your phone to convey your health info can be problematic – there’s always a chance that it’ll be MIA if ever your medical information is needed. Or out of battery. Nothing substitutes a card in your wallet listing your medications, contacts and history. To top that, absolutely nothing substitutes knowing them all by heart.

Aging Boomers: A Mixed Prognosis

This post is by senior fellow, Liz Seegert. Liz is an independent health journalist, co-producer of HealthStyles Radio on WBAI Radio – NYC, and serves as the topic editor for aging for the Association of Health Care Journalists. Follow Liz on Twitter @lseegert.

Photo by Timothy Krause, Flickr Creative Commons

Photo by Timothy Krause, Flickr Creative Commons

Aren’t Baby Boomers (myself included) supposedly the generation of healthy eating, daily exercise, yoga classes and meditation? Are practitioners just better at diagnosing chronic conditions earlier? Or have we been fooling ourselves all along?

Regardless of the reason, it seems many Boomers are setting themselves up for serious, long-term health problems.

The CDC’s National Center for Health Statistics (NCHS) latest report Health, United States, 2014, includes separate profiles of the health of people 55-64 years old, the heart of the “Baby Boom” generation. The findings are a jumble of good news/bad news results that have serious long-term ramifications.

On the one hand, Baby Boomers have longer life expectancy than previous generations; however they are at increasing risk of developing chronic conditions.

Death rates for all causes declined among 55-64 year olds between 2003 and 2013 (6 percent for men and 11 percent for women). Yet, nearly one-third of Boomers reported having two to three chronic conditions; about eight percent said they have four or more.

Between 2009-2012, prevalence of diabetes (19 percent), obesity (40.6 percent), high cholesterol (50.1 percent) and hypertension (51.4 percent) increased among this population, compared with the 1999-2002 period.

Not surprisingly, prescription drug use to manage these diseases also climbed:

  • nearly half (45 percent) of 55-64 year-olds took a prescription cardiovascular drug
  • nearly one-third (31.8 percent) took a cholesterol-lowering drug
  • 16 percent used prescription gastric reflux medications in the past month.
  • Use of cholesterol lowering drugs was 54 percent higher than in the preceding decade (31.8 percent vs. 20.6 percent)
  • 15 percent used a prescription analgesic,
  • 12.9 percent used an anti-diabetic agent and
  • 14.4 percent used a prescription antidepressant.

Smoking rates fell — dropping some eight percent between 2002 and 2012 — but economic disparities persisted. According to the data, those living below 100 percent of poverty ($11,700) were three times as likely to be current smokers as those at 400 percent or more of poverty (32.4 percent vs 11.2 percent). Poor people are not only more likely to smoke, but as this report by the Robert Wood Johnson Foundation shows, are also less likely to receive regular health care than those who are well off.

Boomers are also more stressed than they were in 2002. Slightly more females aged 55-64 reported having recent serious (5.0 percent) or mild-moderate (7.8 percent) psychological distress than did their male counterparts in 2012-2013. (3.7 and 6.3 percent respectively).

While more nutritious and varied food is now available, trends also indicate more consumption of high-fat, high-carb fare, especially fast food.

So what does all this data (and more) mean?

Despite clear messages and unprecedented access to information about healthy eating and exercise, incidence of obesity continues to increase. Apparently sedentary lifestyles have overtaken common sense for many.

Life expectancy is on the rise, but so are health care costs. Medicare will cover most Boomers within 10 years — presenting huge challenges to the U.S. health care delivery system. Worse, Medicare may run out of money by 2030, just when many of us will need more care. Since Medicare may not be around — at least in its current iteration — to pick up the tab, Boomers likely face decades of out-of-pocket expenses for managing chronic illnesses.

It’s also likely that some of these conditions will lead to more serious diseases later in life, like Alzheimer’s or congestive heart failure.

This report highlights some troubling, but still fixable trends among the 55-64 population. Policymakers must account not only for increased longevity among this large cohort, but the realities of what this major hit to the health system will entail.

There is no “magic pill.” Individuals must accept greater responsibility and accountability for their health status, especially when it comes to preventable conditions.

Otherwise millions of boomers risk becoming a generation of less-healthy elders who must figure out alternatives to a safety net that might not exist when it’s most needed.

Media Savvy Nurses & Minnesota Sun Flakes: A Recent Nurse Messenger Training Day

This post is by Barbara Glickstein, co-founder of CHMP. Barbara is a producer and health journalist for WBAI Radio – NYC, a consultant for various health care organizations including The American Nurse Project, and a force behind nurse messenger media & leadership programs, which she leads for nurses around the country. She tweets @bglickstein.

Photo credit: Cyphunk, Flickr Creative Commons.

Photo credit: Cyphunk, Flickr Creative Commons.

Snow in April would paralyze New York. But this was Minnesota, and snow with sunshine would never be an excuse for anything.“Unusual,” Dr. Mary Jo Kreitzer said, but she and her students arrived earlier than the start time that Tuesday morning. They were eager to get media savvy, ready with ideas, all ears for the fourth annual nurse media training, “Media Relations: A Surprising Strategy in the Nurse Leader’s Toolbox Workshop,” sponsored by the Center for Spirituality and Health in Minneapolis, Minnesota.

Fourteen participants came prepared with a health issue they’d focus on and craft into key, media-ready messages. Topics reflected their clinical, educational and research expertise, many bringing long-time passions left on the back burner, revived in this unique training by myself and my colleague, Diana Mason.

Examples ranged from the use of integrative health therapies to reduce pain in children undergoing bone and blood marrow transplants, teaching self-care and mindfulness practices to school-age children to build resiliency and learn healthy coping skills, patient engagement in health care decision-making, digital trends in nursing, and the role of self-care for health care providers in improving patient outcomes.

We were invited back for our annual media training by Dr. Mary Jo Kreitzer, PhD, RN, FAAN, Founder and Director of the Center for Spirituality and Healing and co-director of the Doctorate in Nursing Practice (DNP) program in integrative health and healing, a collaboration between Nursing and the Center DNP program at the University of Minnesota School of Nursing.

Dr. Kreitzer understands that media training is critical to leadership development for nurses. She’s a media maven, in addition to her penchant for commentary on the weather. Whenever the sun peaked out during the all-day media training, she’d alert me and point out the conference room window to the rays that peaked through the gray clouds. I joked with Kit Breshears, Communications Director at the Center for Spirituality and healing, and asked if the precipitation was a flurry of sun flakes, Minnesota style.

Happy to be indoors, the students were engaged, worked hard, and after only 20-minutes of team prep time, nailed their individual on-camera mock television interviews and mock press conferences. Delivered to participants-turned-journalists, the exercise is always a favorite culmination of our media training curriculum.

At the end of the workshop, we asked everyone to share a take-away.  “Developing key messages and using the message triangle. It’s going to help me with all my presentations, including one in class tomorrow night,” said a student participant, speaking about a concept that we use to teach message delivery. Another said, “It built my confidence in so many ways,” while others shared of plans to create a stronger online presence. Many shared appreciation for their new skill of crafting messages, “…on this issue[s] that I care a great deal about.”

They came ready, and with topics of interest. We trained them on message delivery, and walked them through how to develop their own media plans. Then Diana and I  asked them to commit to one post-workshop action. Commitment could include writing an op-ed, starting a blog, or reaching out to a reporter they follow to pitch a story idea to them.

Then one participant asked, “When’s the next Advanced Media Training Workshop scheduled?” A few more chimed in. “Yeah, when will you come back?” We laughed and looked over to our sponsors.“In June. When it isn’t snowing.”

For more information on Nurse Messenger Training, an evidence-based, industry-recognized program by nurse journalists with over twenty-five years in media and health care policy, please contact CHMP.

What’s Your “Healthy Nurse” Score?

This post is by Diana J. Mason, PhD, RN, FAAN, Hunter College Rudin Professor of Nursing, President of the American Academy of Nursing, and one of the founders of CHMP. Diana tweets @djmasonrn.

Photo credit: JE Theriot, Flickr Creative Commons.

Photo credit: JE Theriot, Flickr Creative Commons.

How healthy are you, and how healthy is your workplace? I recently took a survey to find out about my health status, and was disappointed in the score I got. It immediately motivated me to make a stronger commitment to living a healthier life (e.g., less food, more walking), and got me thinking about my work health.

Nurses are notorious for living life on the edge: high rates of smoking, obesity, lack of exercise (except for walking miles on hospital units) too-often match our rates of reported emotional distress from unhealthy work environments.  The survey I took was actually geared around this very premise; American Nurses Association(ANA) has collaborated with Pfizer on the Healthy Nurse initiative that seeks to raise nurses’ awareness of their level of health and factors that could be addressed to become models of health.

The survey is also designed to pursue resources that can help nurses to change their health lifestyle behaviors, along with the health of their workplaces, to do a better job of developing policies and practices that can promote the overall health of nurses. In some cases, this initiative may require public policies, such as those that prohibit smoking or hospitals refraining from offering concessions to fast food chains that have unhealthy food choices.

The initiative is actually a global one. The survey I took on nurses’ personal and workplace health was developed by Pfizer ,and the International Council of Nurses (ICN) as part of a global program focused on nurses’ health. The international survey – Know Your Wellness; Grow Your Wellness – can be found at http://hra.growyourwellness.com/?c=6.

Pfizer and ICN hope to present preliminary results at the ICN Conference in Korea in June, and on the ICN website. Results will also shape the Grow Your Wellness “Healthy Nurse” campaign, including policy recommendations for addressing health in the nursing workplace and strategies for strengthening personal health.

It only takes five minutes to complete the survey — consider it an International Nurses Day gift toward a healthier future for you, and your fellow nurses around the world.

What’s your score?

Workplace Violence Against Nurses: We Are Not Made of Steel

Reni M. Papananias, RN

Reni M. Papananias, RN

This guest post is by Reni M. Papananias, RN, a nurse, photographer, and writer. She’s pursuing her master’s degree in adult and geriatric primary care with a focus on HIV and palliative care at the Hunter-Bellevue School of Nursing in New York City, where she was a student last fall in CHMP senior fellow Joy Jacobson’s narrative writing class for graduate nursing students. Papananias is at work on a memoir about loss and lives in Brooklyn. Names have been changed in this post to protect anonymity.

Nursing is a hard job. It comes with seemingly endless expectations of selflessness, and I have always prided myself on the fact that no matter how tough things get, I don’t cry. I step into my armor and keep the drama at bay—or, rather, that’s what I used to do, until an attack by a patient’s family member left me sobbing under the nurse’s station.

We were waiting for a trauma case to finish in the OR. Minutes before the patient rolled out, a short, stout woman wearing thigh-high boots stormed into the unit and demanded to know where her boyfriend was. She was in a complete rage. “Where’s Dempsey?!” she shouted, eying the unit like a hawk looking for blood.

I approached her and reassured her that Dempsey was not in the recovery room yet, but that everything was okay. I made every effort to be kind and informative. She remained aggressive and accused us of lying to her. Her voice and mood escalated until the doors from the OR swung open and Dempsey arrived safely into the recovery bay.

Things after his arrival were routine: IV fluids and pain meds were administered. I was in charge that evening and I asked the nurse, as I always do, if he needed any help; he insisted that he had it covered. As I turned to walk away, Dempsey’s girlfriend called something out at me. I didn’t hear what she said, so I kept walking. Then she said it again. This time I heard, loud and clear.

I responded, genuinely confused: “Excuse me, are you talking to me?”

“Yeah! I’m talking to you, you *&$% [insert homophobic slur].” My heart started pounding and the tiny hairs on the back of my neck lined up like spurs. I was shaking but managed to choke out the words, “I’m calling security.”

She continued to curse me. Then she threatened my life. “I’ll kill you, you disgusting *&$%.”

That’s when I screamed for help. My co-workers were frozen. They too were in shock. Were they immune to such common acts of workplace violence, the daily subtle yet cutting verbal attacks that nurses face while on duty? That’s when I broke. Tears streamed down my face, I fell to my knees and hid under the desk while she stomped around the unit looking for me.

The rest of the story is a chain of rather discouraging events. Security eventually came but didn’t do much, aside from assess the situation and wait for Dempsey to leave. I overheard someone tell my boss on the phone that my reaction was “emotional.” I was furious. In the days after the event, I was assured that steps were being taken so that this woman wouldn’t be allowed in the hospital again.

These efforts were made in vain, though: seven months later, on another Friday night, Dempsey showed up seeking treatment for a postoperative infection. Dempsey and his girlfriend were transferred to another unit at my manager’s insistence, and while I appreciated this, I found it humiliating that I had to be quarantined for my safety.

They never should have been allowed back on the premises—or at the very least, I should have been informed prior to their arrival. Initially, my manager had asked me if I wanted to press charges, but subtly discouraged me from doing so, suggesting that it might be “a lot to handle” between work and school. No one fully explained my rights or offered supportive services.

This sort of thing happens to nurses more than other health care workers. The Department of Justice reported that nurses are 57% more likely to be assaulted than doctors and that up to 70% of assaults go unreported. There are plenty of reasons for this, including fear of losing one’s job and the normalization of violence against nurses.

Reporting of violent acts against nurses is historically low, despite their high prevalence. Often nurses fear retaliation from hospital administration, lack the knowledge or support from administration due to vague reporting policies, and in turn normalize the behavior, expecting that violence is “just part of the job.” Speaking up may be seen as a sign of weakness or incompetence. Hospital administrators may also be concerned that reporting violent acts may risk patient satisfaction scores and the bottom line.

There remains a need for more research, more workplace violence prevention training for health care workers, and greater public awareness that violence against a nurse is a punishable crime.

I decided that a grassroots approach fit my style. I made it my policy as head nurse to empower my coworkers to become advocates of their own safety. I’m helping them identify escalating behavior and encouraging them to ask for help if they feel threatened.

There are many online guidelines and resources available for nurses and other health care workers. The Emergency Nurses Association has a Workplace Violence Toolkit, and the Occupational Safety and Health Administration just updated its Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. And the National Institutes for Occupational Safety and Health offers a free online course, Workplace Violence Prevention for Nurses.

Nurses are not made of steel, and we DO exist. In fact, perpetuating the idea that there’s no place for emotion in health care is a form of self-inflicted violence. Until nurses stop acting like blank-faced, tiny toy soldiers, our lives will continue to be at risk every time we step into our venerable baby blue scrubs and show up for work.

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